METHODS
The study protocol was approved by the Human Research Ethics Committee of the Istanbul Aydın University (2020/169). The study was carried out in full compliance with the World Medical Association Declaration of Helsinki.
This cross-sectional study involved 100 children aged between 6-13 years old who referred to Istanbul Aydın University Faculty of Dentistry Department of Pediatric Dentistry with their parents for their routine controls or dental treatment. The exclusion criteria included systemic diseases, fixed/removable intra/extra oral appliance and lack of cooperation. Written consent was obtained.
The data on sleeping habits were collected through parent proxy report through Children’s Sleep Habit Questionnaire (CSHQ) that has 33 questions. It is segmented in four main subjects: bedtime resistance, sleep behavior problems, sleep fragmentation and daytime sleepiness. Each item has three response options regarding how often the investigated conditions occurred the previous week. Frequencies were coded as ‘usually’ if the specified behavior occured more than four times a week, ‘sometimes’ for 2-4 times a week and ‘rarely’ for 0-1 time a week. Presence of bruxism and history of traumatic dental injury was recorded as well.
Intra oral examinations were done by one operator in order to avoid inter-operator bias in a clinical setting. Carious lesions were recorded using WHO criteria. The clinical examination included TMJ examination, Angle Classification and malocclusion. Canines and incisor teeth and adjacent soft tissues were examined for clinical findings of traumatic dental injuries.
TMJ examination was rated according to Helkimo anamnestic and clinical pain-dysfunction index. Lack of symptoms were encoded as ‘Grade 0’, mild symptoms (feeling of fatigue in the muscles, muscle stiffness and / or pain, masticating muscular disorders) were encoded as ‘Grade 1’and serious symptoms (not being able to open the mouth too much, jaw locking or dislocation, pain and limitation in mandibular movements, pain in the area of ​​the tmj and / or masticatory muscles, condyle-disc irregularities in tmj) were encoded as ‘Grade 2’.
Occlusion was recorded according to Angle Classification and presence of overjet, anterior open bite, overbite, crowding, spacing, crossbite was also noted as malocclusion.